Surgical instrument



Sept. 4, 1934. w. E. MORSE SURGICAL INSTRUMENT Filed July 11 1932 2Sheets-Sheet l an-on' [1v YEA/T0]? W E M02955 Arr ORA/5Y5 Sept. 4, 1934.w. E. MORSE SURGICAL IN STRUMENT Filed July 11, 1932 2 Sheets-Sheet 2[NI/EN TOR WE M01955 Br M M M 4r TORNEYS' Patented Sept. 4, 1934 UNITEDSTATES PATENT OFFICE 1,972,391 SURGICAL INSTRUMENT William Morse, RapidCity, s. Dak.

Application July 11, 1932, Serial No. 621,795

' 7 Claims. (01. 128-3) My invention relates to surgical instruments andhas for its objects and advantages the provision of an improvedcombination speculum andirrigator embodying a simplification of themanipulation involved in use. The instrument also embodies the functionsof retraction, evacuation or irrigation of body cavities to facilitateexamination, cleansing or surgical manipulation. In the accompanyingdrawings:

ing to the invention;

Figure 2 is a plan view taken along the line 22 of Figure 1;

Figure 3 is a sectional detail view taken along the line 33 of Figure'l;

Figure 4 is a detail view of a portion of the:

Figure '7 is a side elevation of a diiferent con struction illustratingthe fing'ersin both contracted and expanded positions; 2 Figure 8 is atop plan view of the instrument illustrated in Figure 7;

Figure 9 is a sectional detail view taken substantially along the line99 of Figure '7; V

Figure 10 is a plan view of another form of construction; a V

Figure 11 is a side elevation of the instrument shown in Figure 10; andFigure 12 is a sectional detail view illustrating the pivotalconnections for the fingers. In the embodiment selected to illustrate myinvention, I make use of a body 10 in the shape of a cylindrical memberhaving its endsl2 arranged at an, angle to eachother. Referring toFigure 3, the body is provided witha pair of bores14 perpendicular tothe ends 12 and at an angle to the longitudinal axis of the body., Eachbore supports a hollow pintle lficarried by a com-1 partment 18supporting a tubular finger 20. v These fingers are bent backuponthemselves at 22 and have their ends securely fastened within openings24in the compartments 18. Thus it will'be seen that the compartments 18place the fingers 20 in communication with the pintles 16.

Referring, again to Figure 3, the ends ,of the pintles 16 are,providedwith knurled or toothed surfaces Zdarranged at such anglesthatthertwo surfaces mesh to provide an interlocking relation betweenthe two" pintles to prevent relative rotation of, the pintles abouttheir own axes. The ends of the pintles are grooved at 28 for receivingFigure 1 is a side elevation of a device accordthe bifurcated end of asleeve 30positioned within a bore 32 in the body 10. The bifurcated endof the sleeve is shaped to conform to the contour of the grooved surfaceof the sleeve (see Figure 4) and has guiding contact at 34 and 36 withthe edges of the grooves (see Figure 3) Thus it will be seen that thesleeve prevents longitudinal movement of the pintles 16but permitsrotation of the pintles in the bores 14. g

The bore 32'is threaded for the reception of the threaded end of atubular member 38 which, when screwed into place, abuts the sleeve 30 tohold the latter in place. The'tube 38'may be connected with a fluidsource and at the same time it provides a handle for operating thedevice. Since the pintles 16 are arranged at an'angle to'each other, theinner ends of the pintles are separated at 40 which places the pintlesin communication with the tube 38. V

The fingers 20 are narrowed at 42 to facilitate insertion into'thevaginal canal. I have shown the fingers 20 as being bent at 44 toposition the body 10'and its associated structure out of alignment withthe portions 46 of the arms. These portionsdefine the operating lengthof the fingers. Thus it will be seen that the body 10 will not obstructthe sightwhen the instrument is used as a speculum.

At the time ofinsertion, the tube or handle 38 is positionedsubstantially parallel with the portions 46 of the fingers, which bringsthe free ends of the fingers together, as illustrated in Figure 2. Thehandle 38 rotates'abou't the axis of the body 10,'which axis isperpendicular to a line bisecting the angle between the faces 12. Sincethe axes of the pintles are perpendicular to the faces 12, movement ofthe handle from the full line posij tion to the dotted line positionillustrated in Figure 1 causes the arms to be expanded to the positionof Figure'5, thereby distending the canal walls so that a thoroughinspection may be made. 7

Ninety degrees of movement of the handle causes a maximum expansion ofthe fingers. In actual practice, however, the handle may be moved lessthan ninety degrees to effect different amounts of canal distension,depending upon requirements. The frictional relation between the pintles16 and their bores and the compartments '18 and the cam faces 12, whenthe fingers are pressing against the walls of the canal, is usuallysuificient to prevent relative movement between the body'lO and thefingers regardless of the dilating position of thelatter. Ihave'designeda device which may be'operatedwith one hand, and the expanding-action israpid, much more so those previously described.

thereto.

Tapered members 76 are fastened to the inner- When the instrument isused as an irrigator;

it is reversed so that the handle 38 is rotated upwardly for expandingthe fingers. 'The fingers are provided with a plurality of dischargeopemings 48 arranged to direct jets of material in such a manner thatthorough irrigation earnecanal is attained. The ease and conveniencewith I which the instrument may be operated permits the fingers 20 to berepeatedly expanded and-contracted during irrigation to assist inirrigating the tract by alternately distendingand relaxing thetissuefolds. When the fingers are dilated, the,

cervix is positioned between the fingers outof contact with any part ofthe device, so thatjets of fiuid are discharged-directly against'itYThis makes the instrument highly efficient .in ,the application of aprophylactic material.

In Figure '7, I have shown adiiferent construction in which the fingers50 are bent back upon themselves at 52. The free ends of the fingers arenormally in contact with each other, but the fingers remain the same ingeneral contour as In Figures 7 and 8, the bent portions 52 areconnected withbranch tubes 54 bent at 56 to provide 'portions58 alignedperpendicularly with thefaces 60 of the body 62. 3 The body 62 isprovided with threaded. bores 64' communicating with a' smaller opening66 which in turn communicates with a threaded bore 68 for receiving thetube or handle J70. -In; l ig-. ure 9, the bent portions 52 are shown asbeing provided with openings 72 communicating withthe branches 54. Thusit will be seen that the fingers are placed in communication withtheinlet'tube; '70. I have shown the outer endsof the branches 54 asbeing shaped at '74 to substantially sure round the circular portions 52and welded ends of the portions 58 and project slightly into;

the opening 66. Thus it will be seen that the ends of the taperedportions will rotate against the shoulder 78 when the body, 62 isrotated relatively to the fingers 50. -I have shownthreaded sleeves 80mounted upon the portions 58 and, bearing'against the tapered members76.;for hold.- ing the branches in pivotal assemblywiththe body .62.These sleeves arecut away at; 82 to substantially conform tov thecontour: of the tapered portions 76 thereby providing an --e ffectiveseal. The outer ends of the sleeves are slotted at'84 for the receptionof a screw driver to per mit the sleeves to be screwed into the threadedpair tomove away from the other finger in that,

bore64. H v Rotationof the, body '62 will expand the fingers 50 in thesame way as the fingers '20, but in addie tion to such dilation, thebranches of, thefingers: 50 are expanded to the dotted line positionshown in Figure 1 simultaneously" with the; expansion of g the fingersin the other direction. Such expanfingers, and rotation of the body 60,45 in the direction indicated by the arrow 88 will move the pins in thedirection of the dotted line shown, thereby fiexing the bent portion ofthe tubes sulficiently to produce the necessary expansion. The amount ofrotation of the body 62 required to produce .the'necessary dilation ofthe fingers 50 will depend upon the angularity of the faces 60, the.curvature of the. portions 52, and the position of the pins'86. Thepinsv 36 prevent relative movement between the two groups of fingers inone direction, and. a single stop pin 90 upon each endof the body 62prevents relative movement in the opposite direction. Thus the fingerswill always be properly aligned and actuated simulv ;taneously. Eachfinger is provided with a plurality" of'discharge openings located tofunction in the same way as those in the fingers 20.

Theinstrument illustrated in Figures 10, 11, and 12 comprises a Y-shapedtube 92 having hollow fingers 94 pivotally mounted upon the branches 96.Relative rotation between the fingersis prevented by reason of flanges98 knurled in the same way as the pintles 16. These flanges are held ininterlocking relation by a forked memberv 1'00 mounted upon 'thestem ofthe tube 92 and fastened thereto by, a set screw 102. Since the branches96 are arranged at an angle to each other and to the axis of rotation ofthe tube in eitherdirection will cause the fingers 94 to be expanded, asindicated in dotted lines in Figure 10,. The fingers 94 are providedwith a plurality of'discharge openings 104.

To facilitate entry of the instrument, I have flattened the fingers uponone side, so that the point of the instrument defines a gentle curvatureof small dimension. Merely loosening the ,set screw andpulling theforked member away from the flanges 98 permit all the parts to bedisassembled. I

Without further elaboration theforegoing will so fully explain myinvention that others may, by applying current knowledge, readily adaptthe same for use under various conditions of service.

I claim:

1. 'A speculum comprising arms and an operating lever, and mechanicalconnections for expanding said arms by movement of said lever about atransverse axis, said connections including two surfaces lying on acommon wedge, said arms having fiatfaces remaining in contact with saidfirst-named faces throughout the movement, said arms having pintlesperpendicular to said first-named faces, the inner ends of said pintleshavinginterlocking irregularities of contour to prevent relativerotation of said pintles about their own axes.

2.. A device. of the type described comprising a. rotatable member, aplurality of fingers pivotally connected with said body, the pivotalaxes of said fingers being at'an angle to each other and to the axis ofrotation of said body, said fingers, being grouped in pairs, rotation ofsaid member relatively to said fingers causing said pairs of fingers toexpand, and means causing a finger in each pair substantiallysimultaneously with the expandingactionkof said pairs.

.3. A speculum comprising a rotatable body, dilating fingerspivotallyconnected with said body and projecting radially from its axis ofrotation, said bodybeing providedjwith cam means coopcrating withthearms to expand or contract the latter when' said body is rotated,each of said fingers comprising apair. of elements, and means for movingone of said elements in each finger toward or away from the otherelement in that finger simultaneously with the expansion or contraction,respectively, of said fingers.

4. A device of the type described comprising a rotatable body, aplurality of dilating fingers pivotally connected with said body, saidfingers being grouped in pairs, the pivotal axes of said fingers beingarranged at an angle to each other and to the axis of rotation of saidbody, to cause the fingers in one pair to expand or contract withrespect to the other pair, and'means for moving one of said fingers ineach pair toward or away from the other finger in that pairsimultaneously with the expansion or contraction, respectively, of saidpairs, said fingers being provided with conduit means and dischargeports.

5. A device of the type described comprising a hollow branched operatinglever, and hollow fingers pivctally mounted upon the branches of saidlever and having discharge openings.

6. A device of the type described comprising a rotatable body, aplurality of dilating fingers pivotally connected with said body, saidfingers being grouped in pairs, the pivotal axes of said fingers beingarranged at an angle to each other and to the axis of rotation of saidbody, to cause the fingers in one pair to expand or contract withrespect to the other pair, and cam pins moving one of said fingers ineach pair toward or away from the other finger in that pairsimultaneously with the expansion or contraction, respectively, of saidpairs, said fingers being provided with conduit means and dischargeports.

'7. A device comprising multiple channelled elements aligned inapposition, movably attached to a cam element, said cam element providedwith a channelled handle element, and channels connecting the handleelement with the channels of the blade elements so that fluid may beintroduced through or aspirated from the channelled blade elements.

WILLIAM E. MORSE.

